Repetitive transcranial magnetic stimulation for treatment of tardive syndromes: double randomized clinical trial

Khedr, Eman M.; Fawal, Bastawy Al; Abdel-Warith, Abdel-Wahab A.; Saber, Mostafa; Rothwell, John C.

doi:10.1007/s00702-018-1941-x

Cited by 10 publications

(3 citation statements)

References 28 publications

(5 reference statements)

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“…A session of stimulation consisted of 10 trains of 20 Hz stimulation, each lasting for 10 s with an inter-train interval of 25 s. The intensity of stimulation was set at 80% of the rMT for the APB of the contralateral hand with a total 2000 pulses. For sham group the patients received sham stimulation with the same pulse delivery as the 1st group but with the coil placed perpendicular to the scalp similar to previous studies 41 , 45 , 46 . We used this position of the coil because the sham coil is not available in our lab, in addition none of the patients had experienced rTMS previously and would have had no idea what active stimulation feels like.…”

Section: Methodsmentioning

confidence: 99%

A double-blind randomized clinical trial of high frequency rTMS over the DLPFC on nicotine dependence, anxiety and depression

Abdel‐Rahman

Noaman

Fawzy

et al. 2021

Sci Rep

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High frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dorsolateral prefrontal cortex (L-DLPFC) is a widely applied treatment protocol for chronic smoking and major depressive disorder. However, no previous study has measured the effects of rTMS on both nicotine consumption and anxiety/depression in the same volunteers despite the relationship between them. The aim of this work was to evaluate the efficacy of 10 daily sessions of HF-rTMS over the L-DLPFC in chronic cigarette smokers’ addiction and investigate the possible beneficial effects of this treatment procedure on symptoms of depression and anxiety in the same subjects. The study included 40 treatment-seeking nicotine-dependent cigarette smokers. Onset/duration of smoking, number of cigarettes/day, Fagerstrom Test of Nicotine Dependence (FTND), Tobacco Craving Questionnaire-Short Form (TCQ-SF), Hamilton depression and anxiety scales (HAM-D and HAM-A) were recorded. Participants were randomly assigned to the active or the sham treatment group. Those in the active group received 10 trains of 20 Hz stimulation, at 80% of the resting motor threshold (rMT) for 10 consecutive working days over L-DLPFC. Participants were reassessed immediately after treatment, and then 3 months later using all rating scales. There were no differences between active and sham groups at baseline. The cigarette consumption/day, and scores on FTND, and TCQ decreased significantly in both groups (p = 0.0001 for each) immediately after treatment. However, improvement persisted to 3 months in the active group but not in the sham group. Moreover, there was a significant reduction in HAM-D and HAM-A scores immediately after treatment in the active but not the sham group. Subjects with a longer history of smoking had a lower percent improvement in FTND (p = 0.005). Our findings revealed that HF-rTMS over L-DLPCF for 10 days reduced cigarette consumption, craving, dependence, and improved associated symptoms of anxiety and depression.ClinicalTrials.gov Identifier: NCT03264755 registered at 29/08/2017.

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Section: Methodsmentioning

confidence: 99%

A double-blind randomized clinical trial of high frequency rTMS over the DLPFC on nicotine dependence, anxiety and depression

Abdel‐Rahman

Noaman

Fawzy

et al. 2021

Sci Rep

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“…TMS has the advantage of not requiring surgery or general anesthesia, and may have an important role in treatment if further evidence of success and larger studies are completed. In one recent study of 26 patients comparing rTMS versus sham treatment, 2000 rTMS pulses for ten consecutive days showed greater improvement on AIMS exam in bilateral hemispheric rTMS compared with the sham (average 8.3 point decrease for rTMS versus 1.2 point decrease in the sham group) [46].…”

Section: Other Investigational Agents and Clinical Implicationsmentioning

confidence: 96%

“Evaluating and Managing Tardive Dyskinesia in the Older Adult”

Ghosn

Huege

2021

Curr Geri Rep

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Purpose of Review Tardive dyskinesia is an iatrogenic hyperkinetic movement disorder caused by chronic exposure to antidopaminergic agents. The older adult population is particularly vulnerable to developing TD. It is also more difficult to discern the condition given the confounding medical comorbidities that may present at this age including Parkinson’s and other movement disorders that may mimic TD. Recent Findings This paper reviews the most common risk factors, including both modifiable and non-modifiable risk factors. Additionally, the possible causes and proposed pathways of TD and how to correctly diagnose and evaluate TD are discussed. We then focus on how to prevent and manage TD given the current and evolving body of knowledge and evidence. Our stepwise management approach starts by frequent monitoring, discontinuing the culprit antipsychotic, decreasing the dose otherwise; followed by switching to less potent antipsychotics and prescribing VMAT-2 inhibitors. VMAT-2 inhibitors, initially approved for management of Huntington's disease, have been recently showing favorable results in treating other hyperkinetic movement disorders like Tourette’s disease, quickly becoming the first line in the treatment of tardive dyskinesia. The properties of the three different agents belonging to this class: tetrabenazine, deutetrabenazine, and valbenazine will be examined, including side-effect profiles. Finally, recent investigational agents and treatment modalities, including neuromodulation (TMS and DBS) will be reviewed that can be considered when conventional treatment fails or is not tolerated. Summary Older adults treated with antidopaminergic medications are at greatest risk for development of tardive dyskinesia. It is important to recognize risk factors and accurately diagnose TD early. New FDA-approved treatments and investigational agents are now available to manage the condition, however further research to optimally prevent and manage TD in the older adult population remains necessary.

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“…These are only available in three of the Asian countries represented: Thailand, Japan, and China (Table2), and wider access is needed. The older VMAT2, tetrabenazine, is available in South Korea, Malaysia, India, and Thailand (as an orphan drug).The experts considered that, based on promising initial results, the neurostimulation treatments, transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), were of interest for TD management [20,21].…”

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confidence: 99%

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

Bhidayasiri,

Phokaewvarangkul,

Lim

et al. 2024

JMD

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227Tardive dyskinesia(TD) is a movement disorder that exhibits a range of clinical manifestations arising as side effects of treatment with dopamine receptor-blocking agents, primarily antipsychotic drugs (APDs) [1,2].Consequently,its management overlaps different disciplines, in particular, psychiatry and neurology.In practice, this canresult ina gap in management whereby patients receive only one aspect of what should ideally bemultidisciplinarycare. Psychiatrists will naturally focus on controllingthe patient'schallenging psychotic symptomsand may not be specialized in the evaluation of the abnormal movements that are a core manifestation of TD [3,4].As a result, exposure of neurologists to TD patients may be limited to when the condition has becomesevere. Indirect evidence of this is suggested by the psychiatry curriculum for neurology residents developed in collaboration with the Consortium of Neurology Program Directors and the American Association of Directors of Psychiatric Residency Training, approved by the American Academy of Neurology's (AAN)

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Repetitive transcranial magnetic stimulation for treatment of tardive syndromes: double randomized clinical trial

Cited by 10 publications

References 28 publications

A double-blind randomized clinical trial of high frequency rTMS over the DLPFC on nicotine dependence, anxiety and depression

A double-blind randomized clinical trial of high frequency rTMS over the DLPFC on nicotine dependence, anxiety and depression

“Evaluating and Managing Tardive Dyskinesia in the Older Adult”

Neurological Perspectives Should Be Integrated Into the Management of Tardive Dyskinesia—Expert Opinions and Proposed Educational Initiatives in Asia

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